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Nottingham researchers constructed the world's first 3T MRI scanner, thus demonstrating the viability and benefits of high-field MRI. This provided a stimulus for magnet and MRI system manufacturers to develop 3T scanners, which have now become established as the standard platform for high-end clinical MRI studies. We estimate that since 2008: 2500 3T scanners have been installed, representing a global investment of $5 billion;and 30-40 million patient examinations have been performed with 3T MRI scanners. Technical advances which underpinned the Nottingham 3T scanner also impacted on the development of functional MRI, thus opening up a new field of medical research and clinical application. In a subsequent phase of research, the Nottingham group developed ultra-high (7T) magnetic MRI in partnership with PhiIips; forty 7T MRI scanners (current unit cost >$10M) have now been installed across the world.
Theoretical and computational methods for optimising the design of gradient and shim coils with arbitrary shapes and topologies were developed in collaboration with Magnex Scientific as part of a CASE award (2004-07). The resulting software was licenced to Agilent (who now own Magnex Scientific), for whom it has opened up new market opportunities in the supply of novel magnetic resonance imaging systems, leading to £3.4M sales since 2009. The software has also been used by Paramed Medical Systems to improve their `open' magnetic resonance imaging systems, which are optimised for orthopaedic imaging, allow vertical subject posture, and facilitate image-guided treatment, as well as offering a better patient experience. Our work has thus resulted in impact in the economy and healthcare.
The FLAIR (Fluid Attenuated Inversion Recovery) MRI sequence developed at Imperial College has transformed the sensitivity of clinical neuroimaging for white matter brain lesions. FLAIR has had significant commercial impact with incorporation as a standard imaging sequence offered by all manufacturers on their MRI scanners. The inclusion of FLAIR in routine diagnostic MRI protocols in radiology centres worldwide provides evidence of the continued extensive reach of impact for better healthcare outcomes through improved diagnosis and management. The use of FLAIR has led to more powerful Phase II trial designs for development of medicine for stroke, neuroinflammatory disorders, epilepsy and neuro-oncology based on imaging outcomes.
We have developed a new technique of performing cardiac catheterisation in children and adults with congenital heart disease. This has led to the commercialisation of hybrid MRI and X-ray cardiac catheterisation laboratories, a new scientific technique for studying cardiac physiology and pathology and most importantly is being routinely used in clinical practice as it dramatically reduces X-ray radiation exposure (by a factor of 8) and improves the accuracy of physiological measurements leading to better clinical decision making and impact.
Computed tomography (CT) and Magnetic Resonance Imaging (MRI) have revolutionised the practice of medicine by providing improved diagnostic accuracy resulting in improved clinical management and outcome. The evidence-based medicine approach developed by Professor Dixon and his team contributed to the timely evaluation of these technologies. Several of his studies proved improved outcome measures, including reduced mortality, shorter in-patient stay and enhanced diagnostic confidence. Examples include: CT of patients with acute abdominal problems and possible large bowel disease; CT for suspected pulmonary embolism; MRI for lumbar spine disease; MRI for knee and shoulder problems. These informed radiological guidelines adopted across Europe.
Breast cancer affects 1/9 women accounting for significant healthcare resources. The Centre for Magnetic Resonance Investigations in Hull have demonstrated that the addition of MRI to conventional triple assessment does not reduce the re-operation rate for most patients, but instead exposes them to unnecessary investigations. These studies have underpinned the formulation of British, European and American Guidelines on optimal utilisation of MRI in women with early breast cancer scheduled for local excision. The knowledge is widely available on Cancer Help web-sites, helping patients to understand their treatment better. The resulting changes in clinical practice have reduced delays in surgery improving patient treatment whilst saving healthcare resources.
Our research has had a major impact on the way pharmaceutical trials in Alzheimer's disease are conducted. The Boundary Shift Integral technique, which we developed and validated, has changed commercial practice and has become the industry standard for measuring atrophy progression. Our methods have largely replaced previous manual measures and in 2008-13 were used in over 20 large international trials. This had significant economic benefits for several companies providing image analysis services. For UCL alone they generated over £5m of industrial contracts. Additionally, through licensing and collaboration, UCL's research contributed to IXICO establishing a significant market share in this important commercial area.
Magnetic resonance imaging (MRI) provides measurements for quantitative, non-invasive, diagnostic, repeatable monitoring of disease. MRI biomarkers research at the University of Manchester (UoM) spans cancer, lung disease, neurology and more. Our research has produced methods that are widely used by the pharmaceutical industry for drug development decision-making (including ≥ seven AstraZeneca development molecules, plus other pharma), leading to economic benefit, and for healthcare impact (e.g., influencing diagnostic MRI tools introduced by Philips and creating new tools via spin-outs). The methods have been delivered in part via an award-winning UoM spin-out SME, Bioxydyn (incorporated 2009; 2012 turnover £630K; employing 12 staff).
Positron emission tomography (PET) and magnetic resonance imaging (MRI) are two of the most powerful clinical imaging tools. They provide complementary information that is used in the diagnosis of many diseases and in assessing the effect of current and new therapies. Researchers at King's College London, in an international collaboration, demonstrated for the first time the simultaneous acquisition of PET and MR data and the application of the technique in preclinical models. Simultaneous PET-MR systems significantly improve the quality of patient care by allowing both PET and MR examinations to be performed in a single scanning session and by reducing radiation exposure by a factor of two. This pioneering work has led to clinical whole body simultaneous PET-MR systems recently becoming commercially available and there are currently around 40 PET-MR scanners installed in clinical/research institutions worldwide.
Imaging speed is of critical importance in most Magnetic Resonance (MR) imaging applications. King's College London (KCL) researchers have developed spatiotemporal undersamplings, or "k-t" methods, for three-dimensional (3D) imaging and corresponding image reconstruction methods that have increased the speed of imaging significantly, so that particular scans are now 5-7 fold faster. This has directly impacted the experience of the patient whose overall examination time has been reduced from more than 1 hour to less than 30 minutes depending on the application. The technology has been patented and has been implemented by Philips Healthcare, one of the three major manufacturers of MR equipment. A clinical solution platform for 3D MR cardiac perfusion and quantitative flow imaging, based on the technology developed at KCL, has also been launched by the Swiss company, GyroTools LLC.